Various surgical procedures are routinely carried out intravascularly or intraluminally. For example, in the treatment of vascular disease, such as arteriosclerosis, it is a common practice to invade the artery and insert an instrument (e.g., a balloon or other type of catheter) to carry out a procedure within the artery. Such procedures usually involve the percutaneous puncture of the artery so that an insertion sheath can be placed in the artery and thereafter instruments (e.g., catheter) can pass through the sheath and to an operative position within the artery. Intravascular and intraluminal procedures unavoidably present the problem of stopping the bleeding at the percutaneous puncture after the procedure has been completed and after the instruments (and any insertion sheaths used therewith) have been removed. Bleeding from puncture sites, particularly in the case of femoral arterial punctures, is typically stopped by utilizing vascular closure devices, such as those described in U.S. Pat. Nos. 6,045,569; 6,090,130; 7,618,436; 7,749,248; 7,837,705; 7,931,670, and related patents and patent applications, all of which are hereby incorporated by reference.
Typical closure tools or devices such as the ones described in the above-mentioned patents and patent applications place a sealing plug at one side of the tissue puncture site and an anchor on the other side of the tissue puncture site. Successful deployment of the sealing plug requires that it be ejected from within a device sheath or carrier tube into the incision or puncture tract and tamped down to an outer surface of the tissue puncture using a tamping tube (also called a compaction tube). The carrier tube extends from the proximal end to the distal end of the closure tool and includes an outlet at the distal end. The carrier tube can be made of plastic or other material and is designed for insertion through a sheath, and the sheath is designed for insertion through a percutaneous incision in a tissue layer and into a lumen. The sealing plug is initially disposed within the carrier tube, prior to deployment, and the anchor is positioned axially along the carrier tube. When the carrier tube is pulled away from the sealing plug and anchor, after the anchor has been positioned, for example, in a lumen, the sealing plug is deployed into the puncture tract. The carrier tube also houses a tamping device within, and the tamping device advances the sealing plug towards the anchor.
In a manually operated tool, the tamping procedure cannot commence until the carrier tube (within which the tamping device, such as a tamping tube, is located) has been removed so as to expose the tamping tube for manual grasping. The tamping tube is manually grasped and tamped against the sealing plug, setting the sealing plug within the incision or puncture tract, against an outer surface of the tissue puncture. In an automatic tamping system, the closure tool can have an automatic driving mechanism for automatically tamping the sealing plug within the incision or puncture tract toward the outer surface of the tissue puncture. The closure tool can have a tamping tube or tamping rack disposed adjacent to the sealing plug, such that the tamping tube or rack is driven by the automatic driving mechanism to tamp the sealing plug into the desired placement.
Under certain conditions, the sealing plug may need to be ejected from the carrier tube earlier than is usual or expected. In addition, the sealing plug may react with bodily fluids prior to deployment and, thus, make deployment not as easy as expected. Further, easier, more efficient, loading of the sealant plug and knot into the carrier tube would assist in decreasing manufacturing cycle time, and hence boost manufacturing efficiency and productivity. Accordingly, there is a need for improving the mechanism for deployment of the sealing plug at the site of a tissue puncture or incision, and improving manufacturing cycle time for the loaded carrier tube.